Monday, April 11, 2005

"Conscience clauses": The devil really is in the details. Part 1.

Given the current brouhaha over "conscience clauses" -- wherein medical personnel like doctors and pharmacists reserve the right to act like sanctimonious, moralizing assholes in deciding whether or not they're going to serve you -- I thought I'd revisit the whole issue and put down in writing some random thoughts I've been having lately that I don't think have gotten sufficient coverage anywhere. Fair warning -- I'm tired so this piece may be a bit more rambling than normal but I'm sure you can handle it. You're all clever folks. Well, most of you.

And another warning -- while I'm going to consider a number of positions and open questions here, they're purely for the sake of argument and discussion. Let me make it painfully clear that I don't in any way support the notion of a conscience clause (with a single exception I'm going to get to later). In my opinion, if people like pharmicists can't serve the general public fairly and completely, they should have their sorry asses fired. We already have way too many fundamentalist, lunatic dingbats in society as it is without giving them control over prescription drugs as well.

And a final defining ground rule -- while conscience clauses can be applied to numerous vocations, I'm going to keep things simple and discuss just pharmacists and, for better or worse, I'll use the phrase "pro-life pharmacists". It's not my favorite term but, for the sake of discussion, it will do for now. And having laid the foundation, we can start with a simple question that turns out not to have a simple answer:What do "pro-life" pharmacists want?

Sounds like an easy question, doesn't it? Ah, but as I suggested above, the devil is in the details.

Pro-life pharmacists would undoubtedly answer that they want the right to dispense drugs and fill prescriptions in a way that doesn't offend their religious or moral beliefs. But this is a maddeningly vague and incomplete answer. Does this mean that they're prepared to let someone else at the pharmacy do that instead? Does it mean they're prepared to refer customers elsewhere? Does their squeamishness restrict itself solely to prescription drugs, or do they want carte blanche to refuse service based on any product in the store that offends their delicate sensibilities? Oh, yes, lots of questions and not that many clear-cut answers, so here's what I'm proposing.

If pro-life pharmacists want this freedom, I suggest that they be prepared to spell out, in excruciating detail, what rights they're after and how they plan to accommodate customers they refuse to serve. In essence, a contract, which spells out precisely what they can and can't do because, as we all know, if you're not precise, these folks will take every chance they get to push the envelope a little further each time.

To that end, I'm going to propose a set of questions for which there might be surprising answers. And that's coming shortly in part two.